Human Adenovirus-Induced Medulloepitheliomatous Neoplasms in Sprague-Dawley Rats

A direct causal relationship between a human virus and malignant transformations in target cells (sensory neuronal precursors) was suggested by the development of a medulloepitheliomatous neoplasm in the central nervous system. Twenty-six newborn Sprague-Dawley rats were given a single intracerebral inoculation of 0.05 ml of adenovirus fluid, 10^3.5 to 10^4.5 TCID₅₀ HeLa cells/0.1 ml, in the left frontal lobe. Within 37 to 151 days after the virus inoculation, 23 (88.7%) rats autochthonously developed an adenovirus-typical neoplasm in the central nervous system. Nine animals developed a multicentric neoplasm closely related to the ventricular system. Nine others developed solid variously sized neoplasms along the ventricular lumen. Some neoplasms showed multiple foci connected with the stratum subependymale ventriculi olfactorii and the velum medullare of the fourth ventricle. Six spinal cord tumors, located chiefly in the dorsal sensory column, developed within 37 to 61 days after intracerebral inoculation. The remarkably uniform histopathologic appearance of all 23 cases was attributed to a medulloepitheliomatous neoplasm derived from the ependymal anlage. Electron microscopy clearly revealed a solitary cilium within the apical region of many tumor cells. It consisted of a typical ring of nine doublets with no axial pair (a 9+0 pattern), the typical structure of cilia of sensory neuronal origin. The appearance of exuberant neuron-like tumor cells with argyrophile cytoplasmic expansions, neurosyncytial mosaic alignment and myelin-like configurations also suggested a neuronal origin. A paucity of mesenchymal stroma in the neoplastic tissue was noted. No control animals developed tumors.     

Endoscopic naso-pancreatic stent-guided single-branch resection of the pancreas for multiple intraductal papillary mucinous adenomas

INTRODUCTION Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is characterized by dilatation of the mainand/or branch pancreatic ducts, mucin-secretion, and intraductal papillary growth. IPMNs are classified into three types, a main pancreat…     

Reorganization of sensorimotor function after functional hemispherectomy studied using near-infrared spectroscopy

Hemimegalencephaly is a rare congenital disease that occurs with intractable epilepsy and is a childhood developmental disorder. A functional hemispherectomy is indicated for the treatment of hemimegalencephaly with intractable epilepsy. We present a case of hemimegalencephaly in a 6-month-old male. After hemispherectomy, his seizures disappeared completely and postoperative neurological examination showed right hemiplegia. His right arm and limb function were recovered gradually by rehabilitation with passive movement. We investigated cortical activation using near-infrared spectroscopy (NIRS). Serial NIRS showed right cortical activation by passive movement of his right arm. We suggest that NIRS showed the ipsilateral reorganization process as an effect of neurorehabilitation for disconnection of the brain.     

The Variations in the Immunologic Features and Interleukin-6 Levels for the Surgical Treatment of Cardiac Myxomas

Purpose In this study, we propose the existence of a relationship between cardiac myxomas and the immunologic features or interleukin-6 (IL-6), while also considering the optimal treatment of cardiac myxoma, especially “familial myxoma.” Methods In a 19-year period at our hospital, 20 patients underwent 21 operations for cardiac myxomas. The immunologic features and the IL-6 levels were measured pre-operatively in 13 cases and post-operatively in 10 cases. A case of “familial myxoma” was diagnosed based on molecular genetic analyses. Results No patients died in the hospital. The tumor size correlated with the preoperative IL-6 and/or α1-globulin values (P < 0.05). In addition, all of the immunologic features and IL-6 levels normalized by 4 weeks after surgery. “Familial myxoma” demonstrated recurrence without showing increases in either the immunologic features, inflammatory signs, or serum IL-6 levels. Conclusions Patients with cardiac myxoma should therefore be operated on immediately because the possibility that the tumor size might be large when IL-6 and/or α1-globulin values are high. In addition, cases of “familial myxoma” require careful observation and periodic echocardiography after surgery to identify any possible recurrence. Recently, molecular genetic analyses are therefore considered to be an important diagnostic tool for cardiac myxoma, especially “familial myxoma.” Our “familial myxoma” case demonstrated a C769T PRKAR1a mutation, which has also been observed in other cases of “familial myxoma.”     

Radical surgery for advanced pure squamous cell carcinoma of the gallbladder: report of a case

Squamous cell carcinoma (SCC) of the gallbladder is frequently detected at an advanced stage because of its tendency to infiltrate adjacent organs. In addition, more rapid growth of this type of carcinoma compared to that of adenocarcinoma, the most frequent subtype of gallbladder carcinoma, has been reported. Although it is not rare to find squamous cell carcinoma components in cases other than the usual adenocarcinoma of the gallbladder, these cases must be distinguished from those of pure squamous cell carcinoma, as diagnosed in the present case. Pure squamous cell carcinoma is characterized by a well-localized growth, no visceral metastasis, and a rarity or lack of lymph node metastasis, even when the tumor has grown to a large size locally. Prognosis of SCC of the gallbladder has generally been considered poor. Nevertheless, long-term survival after curative resection in patients with SCC of the gallbladder has been sporadically reported. We performed extended right hemihepatectomy with portal vein resection after portal vein embolization for a 55-year-old woman with advanced SCC of the gallbladder. The patient has not developed any signs of recurrence 40 months after the surgery. Although such radical surgery remains challenging, it may lead to a favorable outcome in selected patients with advanced SCC of the gallbladder.